Statistical sensitivity analysis for the estimation of fetal alcohol spectrum disorders prevalence.
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ABSTRACT:
SUBMITTER: Xu R
PROVIDER: S-EPMC6561731 | biostudies-literature | 2019 Jun
REPOSITORIES: biostudies-literature
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Statistical sensitivity analysis for the estimation of fetal alcohol spectrum disorders prevalence.
Xu Ronghui R Honerkamp-Smith Gordon G Chambers Christina D CD
Reproductive toxicology (Elmsford, N.Y.) 20190405
Fetal alcohol spectrum disorders (FASD) are thought to be the leading cause of developmental disabilities worldwide. Accurate estimates of the prevalence of FASD have been lacking. An improved estimate of FASD prevalence in the U.S. was recently reported in a study where multistage methods of active case ascertainment of first-grade children with FASD were utilized in four regions in the U.S. Each method relied on parental consent and therefore had potential non-response bias. We consider weight ...[more]
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Project description:ImportanceFetal alcohol spectrum disorders are costly, life-long disabilities. Older data suggested the prevalence of the disorder in the United States was 10 per 1000 children; however, there are few current estimates based on larger, diverse US population samples.ObjectiveTo estimate the prevalence of fetal alcohol spectrum disorders, including fetal alcohol syndrome, partial fetal alcohol syndrome, and alcohol-related neurodevelopmental disorder, in 4 regions of the United States.Design, setting, and participantsActive case ascertainment methods using a cross-sectional design were used to assess children for fetal alcohol spectrum disorders between 2010 and 2016. Children were systematically assessed in the 4 domains that contribute to the fetal alcohol spectrum disorder continuum: dysmorphic features, physical growth, neurobehavioral development, and prenatal alcohol exposure. The settings were 4 communities in the Rocky Mountain, Midwestern, Southeastern, and Pacific Southwestern regions of the United States. First-grade children and their parents or guardians were enrolled.ExposuresAlcohol consumption during pregnancy.Main outcomes and measuresPrevalence of fetal alcohol spectrum disorders in the 4 communities was the main outcome. Conservative estimates for the prevalence of the disorder and 95% CIs were calculated using the eligible first-grade population as the denominator. Weighted prevalences and 95% CIs were also estimated, accounting for the sampling schemes and using data restricted to children who received a full evaluation.ResultsA total of 6639 children were selected for participation from a population of 13 146 first-graders (boys, 51.9%; mean age, 6.7 years [SD, 0.41] and white maternal race, 79.3%). A total of 222 cases of fetal alcohol spectrum disorders were identified. The conservative prevalence estimates for fetal alcohol spectrum disorders ranged from 11.3 (95% CI, 7.8-15.8) to 50.0 (95% CI, 39.9-61.7) per 1000 children. The weighted prevalence estimates for fetal alcohol spectrum disorders ranged from 31.1 (95% CI, 16.1-54.0) to 98.5 (95% CI, 57.5-139.5) per 1000 children.Conclusions and relevanceEstimated prevalence of fetal alcohol spectrum disorders among first-graders in 4 US communities ranged from 1.1% to 5.0% using a conservative approach. These findings may represent more accurate US prevalence estimates than previous studies but may not be generalizable to all communities.
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